Genetics And Family History
A genetic mutation is a permanent alteration in the DNA sequence that makes up a gene. The result is that one or more of the body’s processes may not work in the way they should.
There are a number of genetic mutations known to increase your risk of developing breast cancer. The most significant mutation identified is known as the BRCA2 mutation.
There’s also evidence that breast cancer can run in families, especially in men who have a first-degree relative who has developed breast cancer, such as a mother or sister.
Routine testing for the faulty genes that cause breast cancer in men isn’t usually carried out on the NHS, unless specifically requested by a specialist. However, some private clinics may offer gene testing. Tests can be expensive, with prices ranging from around £2,000 to £3,000.
What Are The Treatments For Male Breast Cancer
Male breast cancer treatment depends on the type and stage of the disease. Your team of providers will discuss your options with you. Your medical history will help guide what treatment is best for you. Treatments include:
- Surgery: During breast cancer surgery, your provider removes as much of the tumor as possible. You may need a lumpectomy or a mastectomy . Because men have limited breast tissue, mastectomy is more commonly done. You may also need surgery to remove lymph nodes.
- Radiation: Your provider uses targeted radiation therapy to kill cancer cells. Radiation for breast cancer usually follows surgery .
- Chemotherapy : Your provider delivers chemotherapy drugs into a vein, usually through an infusion. You might also take oral chemotherapy pills . These medications kill cancer cells and stop them from multiplying. You may receive chemo treatments over several weeks or months.
- Hormone therapy : Your provider prescribes medications that affect your hormones. These drugs may lower levels of estrogen or block the effects of estrogen. Providers usually use hormone therapy to treat women with breast cancer, but it can be an effective treatment for men, too. These medications treat breast cancers that use hormones to grow. Hormone therapy can be given in the form of pills and/or injections.
- Medications: Several medications kill cancer cells or stop them from growing. Your provider will discuss these medications with you. These may include medications called targeted therapy.
What Causes Male Breast Cancer
Anyone can get breast cancer. Overall health, family history and genetic factors increase the risk of developing the disease. Risk factors of male breast cancer include:
- Age: Men over 60 are more likely to develop breast cancer.
- Overall health: Men with obesity may have gynecomastia . Gynecomastia increases the risk of developing breast cancer.
- Estrogen levels: Certain drugs that contain estrogen cause estrogen levels to rise. Cirrhosis can also increase estrogen levels. A genetic disorder called Klinefelter syndrome increases the risk of several health issues, including breast cancer.
- Family history: Men who have a first-degree relative with breast cancer have a higher chance of the disease.
- Genes: Genetic mutations increase the risk of developing breast cancer. These include changes in the BRCA gene . Mutations in these genes also increase the risk of pancreatic cancer and prostate cancer.
- Radiation therapy: Men who had radiation therapy in the chest or torso have a higher risk of developing breast cancer.
- Testicular issues: People who have had surgery to remove their testicles have a higher risk of breast cancer. Testicle injuries also increase the risk.
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Risk Factors For Male Breast Cancer
Several factors are known to increase the risk that a man will develop breast cancer. But its important to know that many men who develop breast cancer do not have any of these risk factors.
Factors that can increase a mans breast cancer risk include:
The risk of male breast cancer increases as you age. The average age of men diagnosed with breast cancer in the United States is about 67. But breast cancer can occur in young men, too.
A mans risk for breast cancer is higher if any of his close relatives have had breast cancer, and especially if any male relatives have had the disease.
Men who inherit certain genetic mutations from their mothers or fathers have a higher risk of developing breast cancer. A man who inherits a BRCA1 mutation has about a 1% risk of developing breast cancer in his lifetime, compared to a risk of 0.1% for the average man. A man who inherits a BRCA2 mutation has a 7% to 8% risk.
Mutations in the ATM, CHEK2, PALB2, and other genes are also linked to breast cancer in men, but more research is needed to understand those risks.
You may think of testosterone as a male hormone and estrogen as a female hormone. The truth is, both men and women have different levels of testosterone and estrogen in their bodies. Men have less estrogen than women, but all men have some estrogen in their bodies.
Higher levels of estrogen can increase the risk of male breast cancer. Men can have high estrogen levels as a result of:
What To Expect At The Breast Clinic
Your visit to the breast clinic may take several hours.
You can take a partner, close friend or relative with you for company or support. Some people prefer to go on their own.
A doctor or specialist nurse will ask you about your symptoms
You may be asked to fill in a short questionnaire including questions about any family history of breast problems and any medication youre taking.
You will have an examination
The doctor or nurse will check the breast tissue on both sides. As part of the examination its usual to examine the lymph nodes under your arm and around your neck.
You may need further tests
These will usually include one or more of the following:
- An ultrasound scan
- A core biopsy of the breast tissue and sometimes lymph nodes
- A fine needle aspiration of the breast tissue and sometimes lymph nodes
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Don’t Skip Exams That’s How Couric Discovered She Had Breast Cancer
Couric’s cancer was discovered at an exam. “I felt sick and the room started to spin. I was in the middle of an open office, so I walked to a corner and spoke quietly, my mouth unable to keep up with the questions swirling in my head,” she wrote. “During that 24-hour whirlwind, I found out that 85 percent of the 264,000 American women who are diagnosed every year in this country have no family history. I clearly had a lot to learn.”
Dr. Mitchell says, “I honestly think if you are reading this article today, please take this as a reminder to do a self-breast exam if you can. I know recommendations have to flip-flopped over doing self-breast exams and not doing breast exams, but I believe it’s best to err on the side of caution. Women need to be aware of changes in their breasts early. It’s also important to note that normal changes happen to most of us over time. In my practice, I have had countless women present in my office because they noticed a lump on their exam. I also have seen very unfortunate cases when women have ignored extreme, clear signs of breast cancer when the disease is advanced. Please understand your body and listen to that intuition each of us has within. If you feel that your healthcare provider isn’t listening to your concerns, please persist and find another one who will act on them- it might save your life. I will list a few facts about breast cancer that we all should be aware of.”
Diagnosing Breast Cancer In Men
If you have symptoms of breast cancer, such as a hard, painless lump in one of your breasts, your GP will carefully examine you.
During the examination, they’ll also look for other possible signs of male breast cancer, such as swollen lymph nodes .
It’s likely your GP will refer you for further tests if there’s a possibility you may have breast cancer.
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What Causes Breast Cancer In Men
Despite the fact that men dont talk about their breasts, heres a crazy-but-true fact: The tissue in mens chest area includes both milk ducts and mammary glandstwo essential components for womens breasts. Because men arent exposed to large amounts of estrogen during puberty, this tissues typically remains small and undeveloped. The structures are still there, though, and the cells there can grow out of control just like those in womens breast tissues can.
Exactly what triggers cancer in breast cells isnt well understood, but there are a couple of primary suspects. The first is your genes. Genes tell all the cells in your body how to behave, and certain changes or mutations in the DNA of your genes can signal to normal breast cells to become cancerous. Some of these DNA mutations get passed down from your parents but others are caused by things like exposure to cancer-causing chemicals and the way you live your life.
These are some of the factors that increase a guys risk of developing breast cancer:
If Cancer Is Found Tests Are Done To Study The Cancer Cells
- How quickly the cancer may grow.
- How likely it is that the cancer will spread through the body.
- How well certain treatments might work.
- How likely the cancer is to recur .
Tests include the following:
- Estrogen and progesterone receptor test: A test to measure the amount of estrogen and progesterone receptors in cancer tissue. If there are more estrogen and progesterone receptors than normal, the cancer is called estrogen and/or progesterone receptor positive. This type of breast cancer may grow more quickly. The test results show whether treatment to block estrogen and progesterone may stop the cancer from growing.
- HER2 test: A laboratory test to measure how many HER2/neu genes there are and how much HER2/neu protein is made in a sample of tissue. If there are more HER2/neu genes or higher levels of HER2/neu protein than normal, the cancer is called HER2/neu positive. This type of breast cancer may grow more quickly and is more likely to spread to other parts of the body. The cancer may be treated with drugs that target the HER2/neu protein, such as trastuzumab and pertuzumab.
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Male Breast Cancer Signs & Symptoms
Breast cancer in men is very rare and accounts about 1% of all breast cancers. According to the American Cancer Society, the lifetime risk of getting breast cancer as a man is about 1 in 1,000. Because of the low incidence, screening mammography is not recommended for men even for men who have a family history of breast cancer. Because there is no screening exam for men, it is important to be aware of early signs of male breast cancer.
Symptoms of male breast cancer can include the following:
- A hard firm mass or painless lump
- Thickening of the skin around the breast
- Changes to the skin covering the breast, such as dimpling, puckering, redness or scaling
- Nipple changes, such as redness or scaling, or a nipple that begins to turn inward
- Discharge from a nipple
Men who have suspicious physical findings or any persistent signs and symptoms should make an appointment to see their health care provider. If deemed appropriate, your health care provider may refer you to the Carol Milgard Breast Center for a diagnostic mammogram. Dont delay the possibility of an early diagnosis. Some men ignore breast lumps thinking they can rationalize the cause, while others are embarrassed and worry that someone might question their masculinity. Early detection of breast cancer greatly increases treatment options and the likelihood of successful recovery.
What Are The Different Types Of Male Breast Cancer
The most common type of male breast cancer is infiltrating ductal carcinoma, which is also a common type of breast cancer in women. Ductal carcinoma refers to cancers with origins in the ducts of the breast, and the term infiltrating means that the cancer cells have spread beyond the ducts into the surrounding tissue. On the other hand, lobular cancers , common in women, are extremely rare in men since male breast tissue does not normally contain lobules.
Other less common types of cancers of the breast that have been reported in men include ductal carcinoma in situ , cystosarcoma phylloides , and Paget’s disease of the breast . Some other types of breast cancer that occur in men are named for their growth patterns and microscopic appearance of the cancer cells, including papillary carcinoma, inflammatory breast cancer , and medullary carcinoma.
About 85% of breast cancers in men have estrogen receptors on their cell membranes. Estrogen receptors on the cell membranes allow estrogen molecules to bind to the cancer cells. Estrogen binding to the cancer cells can stimulate cell growth and multiplication.
The most common clinical sign of breast cancer in men is a firm, usually painless mass located just under the nipple. There may not be other associated symptoms. The average size of breast cancer in men when first discovered is about 2.5 cm in diameter. The cancer may cause skin changes in the area of the nipple. These changes can include
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What Do Lumps In My Breast Mean
Many conditions can cause lumps in the breast, including cancer. But most breast lumps are caused by other medical conditions. The two most common causes of breast lumps are fibrocystic breast condition and cysts. Fibrocystic condition causes noncancerous changes in the breast that can make them lumpy, tender, and sore. Cysts are small fluid-filled sacs that can develop in the breast.
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Male Breast Cancer Symptoms
The most common symptom of breast cancer in men is a solid mass beneath the areola of the breast. The areola is the darkened and pigmented ring around the nipple. It is distinct from the nipple and smaller in men than women.
- Mobile masses: The mass may be freely mobile, meaning that it moves when it is rubbed, without a feeling as though it is “tethered” to the chest “beneath” the lump.
- Fixed masses: The mass may also be fixed although, if it is truly fixed to the chest behind the lump, this is a bad sign for the progression of the disease.
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Genetic Testing In Men With Or At Risk For Breast Cancer
Breast cancer in men is sometimes caused by inherited mutations in certain genes. You can inherit gene mutations from your mother or your father and can potentially pass them on to your sons and daughters.
The lifetime risk of developing breast cancer is approximately 1% for men who have a BRCA1 gene mutation and 7-8% for men who have a BRCA2 gene mutation, compared to a risk of 0.1% for men in the general population. Mutations in the ATM, CHEK2, PALB2, and other genes are also associated with breast cancer in men, but more research is needed to understand the specific risks from those genes.
According to guidelines from the American Society of Clinical Oncology and the National Comprehensive Cancer Network, all men who have been diagnosed with breast cancer should be offered genetic counseling and genetic testing for genetic mutations linked to a higher risk of breast cancer.
Men who havent been diagnosed with breast cancer but who have a family history of breast, ovarian, pancreatic, or prostate cancer, or who have a family member who was found to have an inherited gene mutation that increases the risk of cancer, should also consider getting genetic testing.
Here are some of the reasons its useful for you and your medical team to know if you have a gene mutation linked to a higher risk of breast cancer:
Fluid Discharge From The Nipple
Nipple discharge is when the nipple secretes fluid, including blood. Per a study published in the Journal of Cellular Immunotherapy, nipple discharge is among the three most commonly-reported symptoms of breast cancer in men. Discharge may occur in one or both nipples and may appear bloody, clear, milky, or green-tinged.
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Medical Issues That Raise Your Risk
If your chest has been treated with radiation for another type of cancer, you have a greater chance of getting male breast cancer. Your odds also go up if you took estrogen for prostate cancer or have testicular issues like an undescended testicle, surgery to remove a testicle, or you’ve had mumps as an adult.
What Is The Most Common Type Of Breast Cancer In Men
The most common type of breast cancer in men is infiltrating ductal cancer. This is cancer that starts in milk duct and spreads to nearby tissues.
Other less-common types of breast cancer in men include inflammatory carcinoma and Paget disease of the nipple. A type of breast cancer called lobular carcinoma in situ is very rare in men. This is because men dont have much lobular tissue. Lobular tissue is where breast milk is made.
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